阴式子宫切除术治疗子宫肌瘤50例临床分析

Clinical Analysis of Transvaginal Hysterectomy in 50 Cases with Uterine Myoma

【目的】探讨子宫肌瘤阴式子宫切除术的方法和经验。【方法】总结分析 1998年 11月至 2 0 0 1年 11月对 5 0例子宫体积≤ 18孕周、无子宫脱垂的子宫肌瘤患者行阴式子宫切除术的临床资料。【结果】 5 0例均成功完成阴式全子宫切除术 ,手术时间 35～ 2 0 5min(中位数 80min) ,出血量 40～ 30 0mL(中位数 10 0mL) ,全部病例均无膀胱损伤、输尿管损伤、直肠损伤、大出血等并发症。术后 6周随诊 ,阴道残端愈合良好。【结论】阴式子宫切除术是治疗子宫肌瘤安全、有效的术式 ,术前应对子宫的大小、活动度、阴道的容量、肌瘤的位置和大小、患者的绝经情况以及术者的经验等多种因素进行评估。

To study the technique and experience of transvaginal hysterectomy for uterine myoma. From Nov. 1998 to Nov. 2001, 50 cases with uterine myoma without prolapse underwent transvaginal hysterectomy. The uterine sizes were not large than 18 weeks of pregnancy. The technique used for reducing the uterine bulk included bisection, myomectomy and morcellation. All the operations were performed successfully. The operating time ranged from 35 to 205 minutes (median 80 minutes). The amount of blood loss ranged from 40 to 300 mL (median 100 mL). No damage to urinary bladder, ureter and rectum. No massive bleeding occurred. Vaginal ends healed completely 6 weeks after the operation. [Conclusion] Transvaginal hysterectomy is a safe and effective option for the treatment of uterine myoma. The sizes, mobility and shape of uterus, compatibility of vagina, size and position of myoma, menopause, operator's skill and experiences should be evaluated before operation.